Compare
Bariatric Surgeries

Procedure

Description

BMI

Est. Wt Loss

Advantages

Disadvantages

Laparoscopic Gastric Band

35 or 30+ comorbidities

15%-20%

Low complication rate, reversible

Challenging for patient to adapt to.

Laparoscopic Sleeve Gastrectomy

40 or 35+ comorbidities

25%-35%

Easiest procedure to adapt to

Irreversible. Vitamin requirement for life. Reflux risk.

Laparoscopic Gastric Bypass

40 or 35+ comorbidities

30%-50%

Powerful operation

Moderately challenging adaptation for patient, vitamin requirement for life, nutritional risks.

40 or 35+ comorbidities

30%-50%

Lower risk of bowel twists than bypass, also simpler operation than bypass.

Larger risk of reflux and ulcers than Gastric Bypass.

Lap. Single Anastomosis Duodenal Switch (SADI)

40 or 35+ comorbidities

30%-50%

Powerful operation

Largest nutritional risks

Description

Variations

Suitable For

Est. Wt. Loss

Advantages

Disadvantages

Minor Complications

Major Complications

10 yr Re-Op Rate

Disclaimers

Plicated band. For patients wishing for the procedure to behave more like a "sleeve".

BMI 35-45, or BMI 30+ with co-morbidities. Younger, highly motivated and organised people who will lose weight with appetite suppression.

15%- 20%

Reversible. Safest procedure. Short hospital stay. Quick recovery

Highest side effect profile while eating compared with other operations. Can have irreversible effect on oesophageal function if band is overtightened.

Reflux. Food intolerances. Regurgitation of lumpy food.

Rare, under 1 in 1000 early on. Band slippage will occur if the band is overtight. Risk of band erosion about 0.3% per year.

50%

Overtightening the band at patient request with daily or near daily vomiting will create significant risk of emergency complications.

Lap. Sleeve Gastrectomy

Banded sleeve gastrectomy. This will cause more swallowing problems and vomiting but may lead to more weight loss.

BMI 40+, or BMI > 35+ comorbidities. Patients who wish to lose weight quickly with lowest side effect profile.

25%- 35%

Good weight loss. Seems to suit the largest range of patients. Low risk of major operative complications and nutritional disturbances.

Irreversible. Requires patients to re- train their eating habits within 2 years or weight regain occurs. Need daily multivitamins and nutritional monitoring.

Reflux, controlled with a tablet in 10%, increasing to 20% at 10 years.

Leaks (internal infections), bleeding and blood clots under 1%. Major side effects in 2-3%.

20%

Small but real risk of dangerous and permanent complications in patients who are noncompliant with multivitamins.

Banded bypass. This is our preferred version as it leads to better long-term weight loss than non-banded bypass.

BMI 40+, or BMI > 35+ comorbidities. People who need to lose more weight (> 40-50kg). Poorly controlled diabetics. Poorly controlled reflux. People who have had previous Lapband or other gastric surgery.

30%- 50%

Reversible/modifiable. Good short and longterm weight loss (25+ years duration) with proven improvement in survival as well as reduction of weight associated diseases

5% of patients get problems with prolonged food intolerances. 2-3% of patients develop small bowel twists - need surgery. Gastric ulceration in 2-3%. Abdominal pain common in patients taking opioid pain meds long term. Need daily multivitamins, 6 monthly Vit B12 injections and nutritional monitoring lifelong.

Food intolerances early on, persisting in 5%. Constipation. Intolerance to very fatty and sugary foods (dumping).

Leaks (internal infections), bleeding and blood clots under 1%. Major side effects in 2-3%. Risk of stomach ulcers in 2- 3%, risk of bowel blockages in 2- 3%.

20%

Small but real risk of dangerous and permanent complications in patients who are non-compliant with multivitamins. Smoking, alcohol and aspirin-like drugs will likely cause bleeding or perforating ulcer disease in patients who are not taking strong antacids. Regular drinkers have an increased risk of becoming alcoholic.

Banded bypass. May lead to better long term weight loss than nonbanded version but has more side effects.

BMI 40+, or BMI > 35+ comorbidities. People who need to lose more weight (> 40-50kg). Poorly controlled diabetics. People who have had previous Lapband or other gastric surgery.

30%- 50%

Reversible/modifiable. Seems similar in results to gastric bypass as well as being easier therefore sometimes safer to perform. Less risk of small bowel blockages post-surgery than a bypass.

5% of patients get problems with prolonged food intolerances. Gastric ulceration occurs more frequently than in gastric bypass. Risk of loose bowels, and greater risk of nutritional problems than a gastric bypass. Need daily multivitamins, 6 monthly Vit B12 injections and nutritional monitoring lifelong.

Food intolerances early on, persisting in 5%. Constipation. Intolerance to very fatty and sugary foods (dumping). Reflux in 5-10%. Loose bowels for a while are not uncommon.

Leaks (internal infections), bleeding and blood clots under 1%. Major side effects in 2-3%. Risk of stomach ulcers in 3-5%. Malnutrition in under 5%.

20%

Small but real risk of dangerous and permanent complications in patients who are non-compliant with multivitamins. Smoking, alcohol and aspirin-like drugs will likely cause bleeding or perforating ulcer disease in patients who are not taking strong antacids. Regular drinkers have an increased risk of becoming alcoholic.

Standard "old fashioned" duodenal switch. Leads to significantly higher risk of malnutrition.

BMI 40+, or BMI > 35+ co-morbidities. People who need to lose more weight (> 40-50kg). Poorly controlled diabetics. People who have had previous Sleeve surgery.

30%- 50%

May prove to be an ideal option for some patients who have regained weight after a Sleeve. Especially for people who have regained weight because of snacking.

We don't have as much longterm data as for other operations. Risk of malnutrition and loose bowels greater than other operations.

Loose bowels and bloating if excessive carbohydrate or fatty food

Leaks (internal infections), bleeding and blood clots under 1%. Major side effects in 2-3%. Severe malnutrition in 5%.50%

Unknown %

Non-compliance with vitamin & mineral supplements highly likely to lead to potentially irreversible nutritional complications